Residency Program in Small Animal Internal Medicine

Contact Dr. Carrie Palm, DVM, DACVIM, with questions atcpalm@ucdavis.edu. The University of California, Davis Veterinary Medical Teaching Hospital offers a 3-year residency program in small animal internal medicine to provide advanced veterinary training to graduate veterinarians. Emphasis is placed on clinical medicine, teaching, and research. Each resident spends approximately 2/3 of the time on clinics in small animal internal medicine and 2 months on related clinical rotations during the program each year. The remainder of each year is allotted to research endeavors, board preparation, vacation, and attending scientific meetings. Appointments to the residency program will be made for 12 months with the opportunity of 12-month renewal upon successful completion of each term.

Objectives of the program: The primary objective of the 3-year small animal internal medicine residency program is to provide advanced veterinary training to graduate veterinarians, with an emphasis placed on clinical medicine, teaching, and clinical research. The residency prepares candidates to become board certified in small animal internal medicine in the American College of Veterinary Internal Medicine (ACVIM).

The need for specific training: There is a need for board certified veterinarians in small animal internal medicine in veterinary academia in particular, as these specialists play a pivotal role in training veterinary students and residents. Many veterinary institutions are hiring clinical track specialists with broader expertise in small animal medicine and whose primary objective is to teach and train students and residents in the clinics.

Courses of activities: Each resident spends approximately 2/3 of the residency on clinics in small animal internal medicine and 2-months on related clinical rotations (oncology, cardiology, clinical pathology, neurology, radiology, ophthalmology, ICU etc…). The remainder of each year is allotted to research endeavors, board preparation, vacation, and attending scientific meetings. The hospital has a heavy clinical caseload, and the resident should expect to be involved in activities of the VMTH for approximately 60 to 70 hours per week.

Scope, nature, and amount of clinical caseload, including emergency rotations: The Small Animal Medicine referral service operates 2 teams, each with 2 faculty members, a second or third year resident, a first year resident, and 5-8 students. In beginning of the first year, residents will receive cases with their primary supervising faculty member in order to obtain “one-on-one” supervision in each faculty member’s area of interest. The receiving schedule can vary but each clinician faculty member receives new cases each week with additional time slots allotted for re-evaluations. Furthermore, each team manages approximately 8-12 inpatients per day. Each resident will also be scheduled for medicine transfers from the emergency service on a rotating basis. Over the weekend, a medicine resident and two medicine students are on duty for emergency transfers with supervision by faculty. After-hours emergency duty for patients coming to the VMTH are shared by dedicated emergency clinicians and residents. Small animal residents have rare primary emergency duty, and the frequency of emergency duty decreases over the 3-year program based on seniority.

Amount and nature of clinical education: Residents are provided with a plethora of organized activities to enhance their medical knowledge, skills, and abilities, including organized student rounds with faculty and residents, resident rounds with faculty and residents only, seminars, journal club, physiology review sessions, research mentoring and board review sessions. A variety of ad hoc conferences, seminars, and local CE courses are scheduled throughout the academic year. An annual endoscopy-training course is also provided during each year of the residency. The 3-year program allows residents to gain excellent proficiency in a variety of diagnostic and therapeutic procedures, including GI endoscopy, bronchoscopy, rhinoscopy, cystoscopy, interventional radiology, feeding tube placement, bone marrow aspiration and biopsy, joint aspirates, etc.

Coursework: The small animal medicine residency does not offer a combined MS or PhD degree, thus there is no formal coursework requirement.

Development of teaching skills and participation in didactic and clinical instruction: Teaching skills are developed in the clinic, through daily rounds and twice-monthly hospital-wide grand rounds presentations. In addition, residents participate in instruction of sophomores and junior vet students in the medical techniques laboratory throughout the year.

Participation in seminars, rounds, journal clubs, and other organized activities: Organized rounds and seminars in support of the residency training program include twice-daily student rounds with faculty presence and oversight, resident case rounds with faculty 2 times weekly, weekly small animal medicine journal club, twice monthly grand rounds, and weekly physiology courses. Residents are not required to attend house officer rounds when on vacation or when rotating through elective rotations but are expected to attend at all other times. The weekly physiology review course provides in-depth review of all organ systems over a 2-year interval. The weekly journal club (1 hour) covers recent advances in the literature and is an environment where residents and faculty critically review the literature.

Development of research skills: All residents are expected to complete one to two clinical research projects in the form of a retrospective case series or a prospective examination of diagnostics or therapeutics and then present the information in a formal scientific setting. Residents are also encouraged to procure research funding via a variety of intramural or extramural funding agencies. Faculty play an integral role in mentoring the residents throughout this grant writing process. Studies are completed during off-clinic time. Research nights are organized every 3 months for residents and faculty to meet in an informal setting to review research projects by residents and to gauge progress. Residents should plan to present their projects with results and conclusions at the annual House Officer Seminar Day, and submission of an abstract to the ACVIM Forum is encouraged. At least one peer-reviewed manuscript is expected during the residency, which fulfills the ACVIM requirement for board certification. The faculty provides supervision and mentoring for each resident to complete their manuscript in a timely fashion.

Development of special academic interests, including activities off campus: Residents are given ample opportunity throughout the 3-year training period to rotate through services such as cardiology, oncology, radiology and neurology. In addition, residents have the opportunity to rotate through other elective rotations, such as ICU. First year residents are encouraged to enroll in a 10-day Clinical Epidemiology course offered by the UC Davis Medical Center. Second and third-year residents are given time off to attend the ACVIM Forum where their examination is taken. Additional off-clinics time is spent on professional development by writing grants, working on research projects, and reading or writing manuscripts. The UC Davis Medical Center is only a 20-minute drive from the VMTH, and opportunities do exist to attend rounds, seminars, etc. when time permits.

Outside rotations and interaction with other services or programs: First year residents are assigned to rotate through ancillary services during their off-clinics time. Specifically, residents are assigned to one week with the clinical pathology service, and 2 weeks with cardiology, oncology, radiology (including ultrasound) and neurology. Third year residents are given additional time to rotate through other specialty services as well.

Structure and organization: The table below provides a template for the 3-year training program:

Year 1

Year 2

Year 3

Internal medicine, directly supervised by an ACVIM Diplomate

36

32

30

Neurology

0

2

0

Oncology

2

0

0

Cardiology

0

2

0

Emergency/Critical Care

0

0

2

ABVS specialty

*Primary case responsibility

4

2

2

Clinical Pathology

1

0

0

Radiology

1

0

0

Ultrasound

0

0

1

Meetings/Board Examinations

0

1

1

Board Study

0

4

6

Research

3

4

5

Vacation

5

5

5

Total

52 weeks

52 weeks

52 weeks

All small animal medicine residents are housed in a large office, and each resident has access to a computer and phone at their desk.

Process of evaluation: Residents are provided with verbal feedback following each clinic rotation by the faculty person assigned to that rotation, and with formal written and verbal feedback that is a culmination of the opinions of all faculty in small animal medicine at least twice yearly. Residents who are performing sub-optimally will be given constructive feedback to improve their performance, and additional review sessions will be provided as needed. Residents who continue to perform sub-optimally despite adequate time for improvement will be subject to dismissal. Appointments to the residency program will be made for 12 months with the opportunity of 12-month renewal upon successful completion of each term. Residents are also requested to provide comments on the training program during the evaluation process.

Certification: The resident must have performed satisfactorily throughout the program and have submitted at least one peer-reviewed manuscript prior to completion of the program. Furthermore, a first author publication is a requirement of the College of ACVIM for board certification. The faculty provides supervision and mentoring for each resident to help complete their manuscript in a timely fashion.

State Licensure: Required. A course is offered at UC Davis yearly for new house officers and faculty to obtain California state licensure.

Advanced degree during residency: Small animal internal medicine residents are usually not permitted to work toward an advanced degree during their residency-training program.

California Driver's License: Not required

MINIMUM QUALIFICATIONS: Graduated from a college or school of veterinary medicine accredited by the AVMA; or possess a certificate issued by the Educational Commission for Foreign Veterinary Graduates (ECFVG); or are legally qualified to practice veterinary medicine in some state, province, territory, or possession of the United States, Canada, or other country.

Have demonstrated unquestionable moral character and professional behavior.

Have completed at least one year of rotating internship or equivalent clinical experience.

Requirements for foreign applicants:In addition to the minimum qualifications above, foreign graduates must also meet the following requirement.

Must be eligible for a TN (Mexico and Canada) or J-1 visa with no bars or home country requirement.

INTERVIEWS FOR RESIDENT CANDIDATES: Applications will be reviewed as they come in through the VIRMP website (BEFORE the application submission deadline). In-person interviews are HIGHLY encouraged and will be by invitation only. If you are interested in being considered for an interview, please be sure to get your application in as soon as possible so that interview arrangements can be made. Interview dates are reserved for Friday, December 1, 2017 and Friday, January 12, 2018.

If candidates have other questions regarding our internal medicine residency program, they are encouraged to contact Dr. Carrie Palm, DVM, DACVIM at cpalm@ucdavis.edu.